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1.
Nature ; 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38600201
2.
Artículo en Alemán | MEDLINE | ID: mdl-38656348

RESUMEN

BACKGROUND AND AIM: Heat and heavy rain can have negative health impacts for people in Germany. Vulnerable groups in particular, such as children and the elderly, are at increased risk and require special precautions. This paper examines how employers of the municipal administration and facilitating organisations perceive the risk of heat and heavy rain for daycare centres and care facilities, and to what extent an exchange takes place between the municipal level and the facilities. In addition, specially developed information materials with recommendations for action for adapting to heat and heavy rain that are aimed at such facilities were evaluated. METHODS: In the summer of 2021, we conducted a quantitative survey. A total of 333 respondents from municipal administrations, facilitating organisations and institutions participated. Descriptive analyses and ANOVAs were conducted. RESULTS: Risk perception and adaptation knowledge concerning heat was perceived higher than concerning heavy rain. The intention to support institutions in finding measures for adaptation was also higher with regard to heat. The majority of interviewees from municipal administrations and institutions communicated with institutions through various channels on different topics including the natural hazards mentioned. The information material was evaluated positively. DISCUSSION: This article shows that facilities are seen as very affected by heat waves. Awareness towards heavy rainfall needs to be raised. The feedback on the information material clearly shows a high need in this area.

3.
Int J Biometeorol ; 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38656351

RESUMEN

The Hindu Kush high-altitude regions of Pakistan are currently experiencing severe consequences as a result of global warming. In this sense, increasing soil erosion and the quick melting of glaciers are two particularly evident effects. In such a scenario, understanding long-term temperature changes is crucial for making accurate forecasts about how the Hindu Kush region may experience regional temperature changes in the future. In this study, the climate tree-ring width (TRW) analysis designated a positive and significant correlation (r = 0.622, p < 0.001) between the TRW chronology and the June to September (summer) mean maximum temperature (MMT). Using the tree-ring width of Pinus wallichiana A. B. Jackson, we reconstructed summer temperatures in the Hindu Kush region from 1790 CE. Statistical analysis showed that the reconstruction model has explained 38.7% of the climate variance during the instrumental period of 1967 to 2018 CE. Five extremely warm summer periods (≥ 4 years; before the instrumental period 1967-2018 CE) of 1804-1830, 1839-1862, 1876-1879, 1905-1910, 1923-1935 CE, and six cold summer periods of 1790-1803, 1832-1838, 1863-1875, 1880-1904, 1911-1922, and 1936-1945 CE have been observed during the past 229 years. Individually, the year 1856 CE experienced severe warmth (31.85 °C), whereas 1794 CE was relatively cooler (29.60 °C). The spectral multi-taper method (MTM) shows significant (p < 0.05) cycles, which take place about every 9.3, 5.7, 4.2, and 3.6 years. In particular, the 9.3-year cycle, which closely aligns with the 11-year solar activity cycle, suggests a potential correlation between solar activity and local temperature fluctuations. Moreover, our reconstruction demonstrates a significant degree of consistency when compared to actual climate data and regional temperature reconstruction series, reporting a strong logic of trust in the reliability and accuracy of our findings. This evidence reaffirms that our reconstruction shows significant and dependable regional temperature signals, notably being representative for the Hindu Kush region.

4.
J Microbiol Biol Educ ; 25(1): e0000524, 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38661412

RESUMEN

The impacts of climate change are and will continue to be far-reaching, and environmental justice communities are disproportionately impacted due to environmental racism and related forms of oppression. Vision and Change in Undergraduate Biology Education encourages that the connection between science and society be explicitly taught in science classrooms. Here, I describe a fictional case study where students decide how to allocate a budget at a non-profit organization tasked with mitigating environmental issues in a town that contains environmental justice communities. Students are each assigned a role in the community and must reach a consensus on their budget in small groups before the whole class votes on a consensus budget. Afterward, students perform a metacognitive activity that encourages them to reflect on the human health impacts of their decisions and how their role impacted their decision-making process. Quantitative and qualitative feedback from students shows that by the end of the course, students appreciate the importance of science literacy in understanding global issues and that they are able to connect environmental justice to their lives and coursework. This case study helps fill an unmet need in climate change education by allowing students to practice empathy in topics related to climate change and environmental justice.

5.
MedEdPORTAL ; 20: 11418, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38645713

RESUMEN

Introduction: Climate change is the single biggest health threat facing humanity, with direct and indirect impacts on mental health, yet health impacts of climate change remain notably absent from most medical school curricula. We describe a timely interactive educational session on climate change and mental health that was implemented and studied on a medical student clinical psychiatry rotation. Methods: We developed a 1-hour introductory session on the mental health impacts of climate change and potential solutions. The session was delivered to third-year medical students on their 4-week clinical psychiatry rotation and included pre- and postsession survey questions assessing their knowledge, comfort, and readiness regarding the topic. Results: Seventy students participated in the session, with 49 students completing the pre- and postsession surveys, giving a response rate of 70%. The average score for the four Likert-scale questions on the survey increased from 2.7 presession to 3.9 postsession on a 5-point scale (1 = strongly disagree, 5 = strongly agree). All questions displayed statistically significant improvement. Qualitative analysis identified knowledge gained about the mental health impacts of climate change as the most important aspect of the session to students. Discussion: The introductory session effectively filled an urgent need in medical education curricula regarding climate change's effects on human health. Overall, distribution of and improvement upon this timely teaching content can serve a valuable role in medical student education as the effects of climate change, particularly on mental health, continue to progress throughout the century.


Asunto(s)
Cambio Climático , Curriculum , Educación de Pregrado en Medicina , Salud Mental , Estudiantes de Medicina , Humanos , Encuestas y Cuestionarios , Educación de Pregrado en Medicina/métodos , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Psiquiatría/educación
6.
J Biotechnol ; 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38663518

RESUMEN

Sustainable farming on ever-shrinking agricultural land and declining water resources for the growing human population is one of the greatest environmental and food security challenges of the 21st century. Conventional, age-old organic farming practices alone, and foods based on costly cellular agriculture, do not have the potential to be upscaled to meet the food supply challenges for feeding large populations. Additionally, agricultural practices relying on chemical inputs have a well-documented detrimental impact on human health and the environment. As the available farming methods have reached their productivity limits, new approaches to agriculture, combining friendly, age-old farming practices with modern technologies that exclude chemical interventions, are necessary to address the food production challenges. Growing genetically modified (GM) crops without chemical inputs can allow agricultural intensification with reduced adverse health and environmental impacts. Additionally, integrating high-value pleiotropic genes in their genetic improvement coupled with the use of modern agricultural technologies, like robotics and artificial intelligence (AI), will further improve productivity. Such 'organic-GM' crops will offer consumers healthy, agrochemical-free GM produce. We believe these agricultural practices will lead to the beginning of a potentially new chemical-free GM agricultural revolution in the era of Agriculture 4.0 and help meet the targets of the United Nation's Sustainable Development Goals (SDGs). Furthermore, given the advancement in the genome editing (GE) toolbox, we ought to develop a new category of 'trait-reversible GM crops' to avert the fears of those who believe in ecological damage by GM crops. Thus, in this article, we advocate farming with no or minimal chemical use by combining chemical-free organic farming with the existing biofortified and multiple stress tolerant GM crops, while focusing on the development of novel 'biofertilizer-responsive GE crops' and 'trait-reversible GE crops' for the future.

7.
Sci Total Environ ; : 172691, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38663591

RESUMEN

The coral predators, crown-of-thorns starfish (COTS, Acanthaster spp.) remain a major cause of extensive and widespread coral loss in Indo-Pacific coral reefs. With increased phylogenetic understanding of these seastars, at least five species appear to be present across different regions. We compare the feeding ecology of these species. Where acroporid corals are prevalent, Acanthaster spp. often exhibit a preference for these corals, with Porites being least preferred, as seen in most species including Acanthaster planci in the northern Indian Ocean and Acanthaster cf. solaris in the west Pacific. In the eastern Pacific, where Acropora is largely absent, Acanthaster cf. ellisii prey on a range of coral species, including Porites. Coral predation by COTS is influenced by several factors including food availability, coral nutritional value, protective crustaceans and coral defenses, with differences in feeding ecology and behaviour emerging across the different COTS species. Feeding behaviour of COTS can act to increase coral species richness by reducing the dominance of fast-growing species. In outbreaking populations, COTS impacts reef systems by reducing live coral cover, eroding reef complexity and causing shifts in reef trophic structure. Where data are available, we synthesise and contrast the feeding preferences and foraging behaviour of Acanthaster species, and their impact on coral assemblages across the different species and regions. For areas where focal predation on Acropora occurs, also the fastest growing coral with the greatest recovery potential following mass mortality events, the combination of climate change and COTS outbreaks presents an imminent threat to coral reefs. This is exacerbated by the dietary flexibility of Acanthaster species. The impacts of heatwaves, COTS and other stressors are creating a negative feedback loop accelerating coral reef decline.

8.
Sci Total Environ ; : 172571, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38663592

RESUMEN

Arctic fjords are considered to be one of the ecosystems changing most rapidly in response to climate change. In the Svalbard archipelago, fjords are experiencing a shift in environmental conditions due to the Atlantification of Arctic waters and the retreat of sea-terminating glaciers. These environmental changes are predicted to facilitate expansion of large, brown macroalgae, into new ice-free regions. The potential resilience of macroalgal benthic communities in these fjord systems will depend on their response to combined pressures from freshening due to glacial melt, exposure to warmer waters, and increased turbidity from meltwater runoff which reduces light penetration. Current predictions, however, have a limited ability to elucidate the future impacts of multiple-drivers on macroalgal communities with respect to ecosystem function and biogeochemical cycling in Arctic fjords. To assess the impact of these combined future environmental changes on benthic productivity and resilience, we conducted a two-month mesocosm experiment exposing mixed kelp communities to three future conditions comprising increased temperature (+ 3.3 and + 5.3 °C), seawater freshening by ~ 4 and ~ 6 units (i.e., salinity of 30 and 28, respectively), and decreased photosynthetically active radiation (PAR, - 25 and - 40 %). Exposure to these combined treatments resulted in non-significant differences in short-term productivity, and a tolerance of the photosynthetic capacity across the treatment conditions. We present the first robust estimates of mixed kelp community production in Kongsfjorden and place a median compensation irradiance of ~12.5 mmol photons m-2 h-1 as the threshold for positive net community productivity. These results are discussed in the context of ecosystem productivity and biological tolerance of kelp communities in future Arctic fjord systems.

9.
Sci Total Environ ; : 172730, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38663596

RESUMEN

BACKGROUND: Heat exposure during pregnancy can increase the risk of preterm birth (PTB) through a range of potential mechanisms including pregnancy complications, hormone secretion and infections. However, current research mainly focuses on the effect of heat exposure on pathophysiological pathways of pregnant women, but ignore that that maternal heat exposure can also cause physiological changes to the fetus, which will affect the risk of PTB. OBJECTIVE: In this study, we aimed to explore the mediating role of fetal heart rate (FHR) in the relationship between maternal heat exposure and PTB incidence. METHODS: We assigned heat exposure to a multi-center birth cohort in China during 2015-2018, which included all 162,407 singleton live births with several times FHR measurements during the second and third trimesters. We examined the associations between heat exposure, FHR and PTB in the entire pregnancy, each trimester and the last gestational month. The inverse odds ratio-weighted approach applied to the Cox regression was used to identify the mediation effect of heat exposure on PTB and its clinical subtypes via FHR. FINDINGS: Exposure to heat significantly increased the risk of PTB during the third trimester and the entire pregnancy, hazard ratios and 95 % CIs were 1.266 (1.161, 1.379) and 1.328 (1.218, 1.447). Heat exposure during the third trimester and entire pregnancy increased FHR in the third trimester by 0.24 bpm and 0.14 bpm. The proportion of heat exposure mediated by FHR elevation on PTB and its subtype ranged from 3.68 % to 24.06 %, with the significant mediation effect found for both medically indicated PTB and spontaneous PTB. CONCLUSIONS: This study suggests that heat exposure during pregnancy has an important impact on fetal health, and FHR, as a surrogate marker of fetal physiology, may mediate the increased risk of PTB caused by extreme heat. Monitoring and managing physiological changes in the fetus would constitute a promising avenue to reduce adverse birth outcomes associated with maternal heat exposure.

11.
12.
Nature ; 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38664562
13.
Laryngoscope Investig Otolaryngol ; 9(2): e1221, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38623079

RESUMEN

Objective: To determine the carbon savings potential of incorporating virtual care into surgical care pathways for pediatric patients with obstructive sleep apnea or otitis media with effusion. Methods: Pediatric patients with obstructive sleep apnea or otitis media with effusion were not enrolled, instead, a modeling cohort study design was used. This study utilized the British Columbia healthcare system and geography to model emissions. Care pathways were developed for pediatric patients with obstructive sleep apnea or otitis media with effusion requiring care at a tertiary pediatric center. Home addresses were located at the geographical center of the two most populated municipalities within each of the 10 most populated regional districts in 2020. Virtual visits replaced up to three clinically equivalent in-person visits. Emissions (kgCO2e) for transport and virtual visits were estimated. Population-weighted means and descriptive statistics were calculated. Results: Utilizing 1, 2, or 3 virtual visits in the obstructive sleep apnea care pathway yielded potential emissions savings of 19.9%, 39.9%, and 59.8% respectively. Integrating 1, 2, or 3 virtual visits into the otitis media with effusion care pathway produced potential emissions savings of 16.6%, 33.2%, and 49.7%, respectively. Integrating 3 virtual visits can save up to 2156.8 kgCO2e per patient. Conclusions: Appropriately conducting up to 50% of clinical encounters virtually for children with obstructive sleep apnea or otitis media with effusion reduced theoretical carbon emissions. For a single child, emission savings could reach over 2150 kgCO2e. Level of Evidence: Level 5.

14.
Physiol Mol Biol Plants ; 30(2): 349-367, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38623161

RESUMEN

Highly repetitive adverse environmental conditions are encountered by plants multiple times during their lifecycle. These repetitive encounters with stresses provide plants an opportunity to remember and recall the experiences of past stress-associated responses, resulting in better adaptation towards those stresses. In general, this phenomenon is known as plant stress memory. According to our current understanding, epigenetic mechanisms play a major role in plants stress memory through DNA methylation, histone, and chromatin remodeling, and modulating non-coding RNAs. In addition, transcriptional, hormonal, and metabolic-based regulations of stress memory establishment also exist for various biotic and abiotic stresses. Plant memory can also be generated by priming the plants using various stressors that improve plants' tolerance towards unfavorable conditions. Additionally, the application of priming agents has been demonstrated to successfully establish stress memory. However, the interconnection of all aspects of the underlying mechanisms of plant stress memory is not yet fully understood, which limits their proper utilization to improve the stress adaptations in plants. This review summarizes the recent understanding of plant stress memory and its potential applications in improving plant tolerance towards biotic and abiotic stresses.

15.
Heliyon ; 10(7): e29327, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38623203

RESUMEN

Pre-harvest sugarcane burning persists in many countries though there are policies prohibiting the practice. As problems related to sugarcane harvesting are complex, a thorough understanding of the problems for policy formulation is required. The objective of this study was to reanalyze or reframe problems of sugarcane harvesting and pre-harvest sugarcane burning. Concepts of wicked problems, practical reasoning and policy reframing were applied. The study used a participatory modeling approach to illustrate the case of Thailand. Wickedness was shown by complexity and uncertainties of factors intertwining with values related to adoption of harvesting methods; green mechanical, green manual and burnt manual. As timeliness of harvest was the top priority, the burnt method was considered more efficient. It was easier, faster, cheaper and more suitable under unfavorable circumstances for the green methods. The policy to reduce burnt-harvested sugarcane was not so effective and also led to the undesired 'green but unclean' method. To frame harvesting problems based on emissions of fine particulates (PM2.5) from sugarcane burning was not a good choice. Incomplete problem sense-making and poor problem frame were indicated. Most farmers were unable to associate sugarcane burning with environmental problems of PM2.5 (and also global warming/climate change) and livelihood impacts. Nevertheless, a larger concern over climate variations was perceived by a majority of farmers. Farmers who adapted relied primarily on green harvesting and the use of residues as trash blankets. Through policy reframing, inefficient green harvesting was seen as a better frame. The new frame enabled farmers linking agricultural practices to sustainability of environment, productivity and livelihoods in the context of climate change. Using participatory modeling for reframing policy problems in general and wicked problems in particular was shown to be powerful and contributing to originality.

16.
Ecol Evol ; 14(4): e11283, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38623518

RESUMEN

Climate change poses a significant threat to endemic and endangered montane bird species with limited elevation and temperature ranges. Understanding their responses to changes in climate is essential for informing conservation actions. This study focused on the montane dwelling Yellow-throated Apalis (Apalis flavigularis) in Malawi, aiming to identify key factors affecting its distribution and predicting its potential distribution under different climate change scenarios. Using an ensemble species distribution modeling approach, we found that the mean temperature of the driest quarter (Bio9), mean temperature of the wettest quarter (Bio8), and precipitation seasonality (Bio15) were the most important variables that influenced the distribution of this species. Across future climate scenarios, the species' geographic range declined where range losses varied from 57.74% (2050 RCP 6.0) to 82.88% (2070 RCP 6.0). We estimate its current range size to be 549 km2 which is lower than some previous estimates of its spatial distribution. Moreover, our projections indicate that under future climate scenarios, the species will shift to higher elevations with a large proportion of suitable areas located outside forests, posing challenges for adaptation. Our results suggest that the species may be under greater threat than previously thought; hence, urgent conservation actions are required. We recommend reinforcing the protection of areas predicted to remain suitable under future climate scenarios and the development of a species conservation action plan.

17.
Proc Natl Acad Sci U S A ; 121(16): e2215677121, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38588420

RESUMEN

Effective policies for adaptation to climate change require understanding how impacts are related to exposures and vulnerability, the dimensions of the climate system that will change most and where human impacts will be most draconian, and the institutions best suited to respond. Here, we propose a simple method for more credibly pairing empirical statistical damage estimates derived from recent weather and outcome observations with projected future climate changes and proposed responses. We first analyze agricultural production and loan repayment data from Brazil to understand vulnerability to historical variation in the more predictable components of temperature and rainfall (trend and seasonality) as well as to shocks (both local and over larger spatial scales). This decomposed weather variation over the past two decades explains over 50% of the yield variation in major Brazilian crops and, critically, can be constructed in the same way for future climate projections. Combining our estimates with bias-corrected downscaled climate simulations for Brazil, we find increased variation in yields and revenues (including more bad years and worse outcomes) and higher agricultural loan default at midcentury. Results in this context point to two particularly acute dimensions of vulnerability: Intensified seasonality and local idiosyncratic shocks both contribute to worsening outcomes, along with a reduced capacity for spatially correlated ("covariate") shocks to ameliorate these effects through prices. These findings suggest that resilience strategies should focus on institutions such as water storage, financial services, and reinsurance.

18.
Environ Sci Technol ; 58(16): 7032-7044, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38602351

RESUMEN

High-elevation mountains have experienced disproportionately rapid warming, yet the effect of warming on the lateral export of terrestrial carbon to rivers remains poorly explored and understood in these regions. Here, we present a long-term data set of dissolved inorganic carbon (DIC) and a more detailed, short-term data set of DIC, δ13CDIC, and organic carbon from two major rivers of the Qinghai-Tibetan Plateau, the Jinsha River (JSR) and the Yalong River (YLR). In the higher-elevation JSR with ∼51% continuous permafrost coverage, warming (>3 °C) and increasing precipitation coincided with substantially increased DIC concentrations by 35% and fluxes by 110%. In the lower-elevation YLR with ∼14% continuous permafrost, such increases did not occur despite a comparable extent of warming. Riverine concentrations of dissolved and particulate organic carbon increased with discharge (mobilization) in both rivers. In the JSR, DIC concentrations transitioned from dilution (decreasing concentration with discharge) in earlier, colder years to chemostasis (relatively constant concentration) in later, warmer years. This changing pattern, together with lighter δ13CDIC under high discharge, suggests that permafrost thawing boosts DIC production and export via enhancing soil respiration and weathering. These findings reveal the predominant role of warming in altering carbon lateral export by escalating concentrations and fluxes and modifying export patterns.

19.
Chemosphere ; 357: 141978, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38608774

RESUMEN

Human impacts on wild populations are numerous and extensive, degrading habitats and causing population declines across taxa. Though these impacts are often studied individually, wild populations typically face suites of stressors acting concomitantly, compromising the fitness of individuals and populations in ways poorly understood and not easily predicted by the effects of any single stressor. Developing understanding of the effects of multiple stressors and their potential interactions remains a critical challenge in environmental biology. Here, we focus on assessing the impacts of two prominent stressors associated with anthropogenic activities that affect many organisms across the planet - elevated salinity (e.g., from road de-icing salt) and temperature (e.g. from climate change). We examined a suite of physiological traits and components of fitness across populations of wood frogs originating from ponds that differ in their proximity to roads and thus their legacy of exposure to pollution from road salt. When experimentally exposed to road salt, wood frogs showed reduced survival (especially those from ponds adjacent to roads), divergent developmental rates, and reduced longevity. Family-level effects mediated these outcomes, but high salinity generally eroded family-level variance. When combined, exposure to both temperature and salt resulted in very low survival, and this effect was strongest in roadside populations. Taken together, these results suggest that temperature is an important stressor capable of exacerbating impacts from a prominent contaminant confronting many freshwater organisms in salinized habitats. More broadly, it appears likely that toxicity might often be underestimated in the absence of multi-stressor approaches.

20.
EBioMedicine ; 103: 105119, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38631093

RESUMEN

BACKGROUND: Cardiovascular disease (CVD) has been found to be particularly vulnerable to climate change and temperature variability. This study aimed to assess the extent to which human-induced climate change contributes to future heat-related CVD burdens. METHODS: Daily data on CVD mortality and temperature were collected in 161 Chinese communities from 2007 to 2013. The association between heat and CVD mortality was established using a two-stage time-series design. Under the natural forcing, human-induced, and combined scenarios, we then separately projected excess cause-/age-/region-/education-specific mortality from future high temperature in 2010-2100, assuming no adaptation and population changes. FINDINGS: Under shared socioeconomic pathway with natural forcing scenario (SSP2-4.5-nat), heat-related attributable fraction of CVD deaths decreased slightly from 3.3% [95% empirical confidence interval (eCI): 0.3, 5.8] in the 2010s to 2.8% (95% eCI: 0.1, 5.2) in the 2090s, with relative change of -0.4% (95% eCI: -0.8, 0.0). However, for combined natural and human-induced forcings, this estimate would surge to 8.9% (95% eCI: 1.5, 15.7), 14.4% (95% eCI: 1.5, 25.3), 21.3% (95% eCI: -0.6, 39.4), and 28.7% (95% eCI: -3.3, 48.0) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. When excluding the natural forcing, the number of human-induced heat-related CVD deaths would increase from approximately eight thousand (accounting for 31% of total heat-related CVD deaths) in the 2010s to 33,052 (68%), 63,283 (80%), 101,091 (87%), and 141,948 (90%) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. Individuals with stroke, females, the elderly, people living in rural areas, and those with lower education level would exhibit heightened susceptibility to future high temperature. In addition, Southern and Eastern regions of China were expected to experience a faster increase in heat-related attributable fraction of CVD deaths. INTERPRETATION: Human activities would significantly amplify the future burden of heat-related CVD. Our study findings suggested that active adaptation and mitigation measures towards future warming could yield substantial health benefits for the patients with CVD. FUNDING: National Natural Science Foundation of China.

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